As the COVID-19 pandemic continues around the globe, the world’s researchers learn more and more about the virus, some of which is quite surprising. With the nonstop media reporting about coronavirus, it is sometimes difficult to separate what is true about the disease and what is not. Let’s delve into some COVID information and decide whether it is a COVID fact or COVID fiction.
Saliva is as good as mucous for COVID detection
COVID fact or COVID fiction?
Currently there are two main types of tests for COVID: The PCR (polymerase chain reaction) test and the antibody test. The PCR test is performed by a health care worker who swabs a patient’s nose or throat. The mucous is combined with a chemical (a reagent) and run on a machine in a laboratory. It detects whether the virus is present in the nose or throat. Antibody testing requires drawing blood and reflects the body’s immune response to the virus, rather than detecting the virus itself. The antibody test looks at the immune response. If the test is positive for IgM it means that the infection is still active. If the test shows that IgG is positive, it means there was a previous infection. These current methods are both limited in the following ways. They require expensive machines to run the tests and since the tests are run in batches, it takes several days for the results. The reagents used for the tests are also expensive and scarce. In addition, health care workers are exposed, since they must collect the specimens to run the tests. Now, new tests are available that can overcome these limitations. One test requires a patient to collect saliva and send it to the lab. It was developed by Yale University, uses commonly available reagents and a sterile urine specimen cup for collection. When evaluated the saliva test was as accurate as the nasal swab test. This method is currently being used at the University of Illinois to test students and faculty in an effort to remain open during the pandemic. Another test uses mucous (collected by the patient) placed on a card, about the size of a credit card. Reagents are added to the card and the results are available in 15 minutes. The cards can be mass-produced, 50 million are estimated to be available starting in October, and cost only $5. These new tests provide rapid results (in minutes rather than days), require no expensive machinery, use reagents that are commonly available, do not expose medical personnel to the virus and are cheap. Once these new tests become widely available, they can test asymptomatic people (such as children going back to school, workers going back to the office, or hospital staff) and can identify asymptomatic carriers before they infect others and spread the virus. This will control the pandemic and get the economy back on track.
COVID Fact
Once you have COVID you can’t be reinfected
COVID fact or COVID fiction?
Once someone has COVID, the body produces antibodies to fight the infection. If the infection is successfully fought off, the antibodies remain. Unfortunately, it has been shown that the level of antibodies in the blood diminish over time and disappear within a few months, potentially putting the person at risk for another COVID infection. Until recently, there had been no documented cases of reinfection. In August, two cases came to light. The first one occurred in Hong Kong. A young healthy person was infected with two distinctly different strains of virus 142 days apart. Another patient from Nevada, who is 25 years old, was infected twice, 48 days apart. In both cases, the second infection was asymptomatic, suggesting the immune system did its job of protecting the patient. This teaches us that patients who have had COVID still need to comply with wearing masks and social distancing. In addition, they should receive a vaccine, once one becomes available. Unfortunately this also tells us that a vaccine may not provide protection for life and a periodic booster may be necessary.
COVID fiction
The optimal separation for social distancing is six feet
COVID fact or COVID fiction?
Why do health officials recommend staying six feet apart to reduce the risk of infection? Why not five feet, or ten feet, or three feet? It turns out the current rule on safe physical distancing is based on outdated science. The study of respiratory droplet emission started in the 1800’s. In 1897, it was determined that six feet was a safe distance since it was observed that droplets did not travel further than six feet. Modern science has shown that droplet spread is more complicated. For example, droplets come in different sizes and travel different distances based on the force of emission (for example coughing or sneezing sends droplets further), ventilation patterns and whether one is indoors or outdoors. A more nuanced approach to social distancing should take into account all of these factors. If one is in a high-risk setting (indoors, poor ventilation), physical distancing should be enforced. If one is outdoors or in another low risk setting, distancing can be less.
COVID fiction
This winter’s flu season will be worse than in the past
COVID fact or COVID fiction?
As fall and winter approach, health officials are anxious and bracing for a new onslaught of patients. The addition of a flu season on top of the coronavirus pandemic could push hospitals’ capacities to the limit. No one knows the impact of flu (plus other respiratory viruses typically prevalent in the winter) and COVID. Will patients be twice as sick? Will a recovered patient be more or less susceptible to other viruses after recovering from COVID? There is much to learn but there is some encouraging data coming from the Southern hemisphere (which is just at the tail end of it’s winter and flu season). Countries such as Chile and Argentina have noted that the flu has “practically disappeared” this year. Chile had 1,100 flu cases this year versus 20,000 cases in 2019 while Argentina reported 151,000 infections this year compared with 420,000 last year. Other Southern hemisphere countries, South Africa, Australia, New Zealand, are reporting similar results. Officials attribute the decline of the flu to mask wearing, social distancing, travel restrictions, school closures and telemedicine (patients aren’t sitting in doctor’s offices being exposed to viruses). In addition, there has been an increase in flu vaccination rates. Despite the good news from the other side of the world and to mitigate the potential one-two punch of flu and COVID in the Northern hemisphere, it is prudent to get the flu vaccine in September or early October (to ensure immunity is in place as flu season hits). The vaccine manufacturers are doing their part, announcing a major surge in vaccine production to meet the demand this year.
COVID fiction- probably
The coronavirus directly attacks the heart
COVID fact or COVID fiction?
Myocarditis, or inflammation of the heart, can be due to a variety of agents including viruses. Now there is evidence that the coronavirus directly infects the heart, causing inflammation of the heart and myocarditis. Symptoms of myocarditis include shortness of breath (due to congestive heart failure, fluid in the lungs), chest pain (mimicking a heart attack) and irregular heart rhythms (which can lead to sudden cardiac death). Many patients with COVID display the effects of myocarditis for weeks or months after the acute illness. A German study showed 60% of patients had myocarditis up to two months after the initial diagnosis. A study of healthcare workers found evidence of myocarditis 10 weeks after recovering from COVID. There is no specific treatment for myocarditis. Sometimes steroids work, but the data is not conclusive. Mostly patients must rest for at least three to six months until the inflammation has resolved. Rest is important as activity or exercise can trigger irregular heart rhythms and sudden cardiac death. This is especially important in clearing athletes who have had COVID to return to their sport. This has become a big issue in the sports world as more data has emerged about myocarditis in athletes. A Boston Red Sox pitcher was diagnosed with myocarditis and shut down from pitching for the season. A college football player was diagnosed with myocarditis. In fact, two college conferences cancelled their football seasons over fears of myocarditis. This was triggered by a study showing that about 15% of college athletes with prior COVID had myocarditis.
COVID fact
To decrease your risk for COVID, wear a mask and follow social distancing keeping in mind the relevant factors such as venue (indoors or outdoors), crowd size and ventilation patterns. In addition, get your flu vaccine earlier rather later. Lastly, consider sitting out the 2020 college football season.
